摘要
目的探讨组织间插植并腔内近距离调强适形放射治疗复发性宫颈癌疗效及毒副反应。方法 65例手术+放疗与根治性放疗后复发的宫颈癌采用不同治疗方法,A组37例采用组织间插植+腔内近距离调强适形放射治疗,B组28例采用三维适形+传统腔内放射治疗,比较A、B两组的疗效差异与毒副反应。结果 A组37例复发性宫颈癌完全缓解+部分缓解33例、稳定+进展4例;B组28例复发性宫颈癌完全缓解+部分缓解18例、稳定+进展10例,两组近期疗效比较有统计学意义(χ2=5.849,P=0.016)。1、2、3年局控率,A组分别为86.2%、73.7%、43.7%,B组分别为77.7%、59.6%、11.8%,差异有统计学意义(χ2=4.575,P=0.032);1、2、3年生存率,A组分别为88.5%、75.4%、47.6%,B组分别为78.2%、60.0%、23.8%,差异有统计学意义(χ2=4.140,P=0.042)。毒副反应:放射性膀胱炎发生率A、B两组分别为10.8%、32.1%,差异有统计学意义(χ2=4.533,P=0.033);放射性直肠炎发生率A、B两组分别为13.5%、39.3%,差异有统计学意义(χ2=5.705,P=0.017);放射性盆腔纤维化发生率A、B两组分别为13.5%、14.3%,差异无统计学意义(χ2=0.008,P=0.929)。结论复发性宫颈癌组织间插植+腔内近距离调强适形放射治疗与体外三维适形放疗+传统腔内放射治疗相比有明显优势,具有疗效好、疗程短、毒副反应轻的特点。
Objective To investigate the curative effect and toxicity of interstitial implantation intensity modulated brachytherapy for recurrent cervical cancer. Methods 65 recurrent patients with cervical cancer that have received radical surgery+radiotherapy or radiotherapy were treated with different methods,Group A(37 cases)were treated with interstitial implantation+intensity-modulated conformal brachytherapy,and Group B(28 cases)with three-dimensional conformal radiotherapy+intracavitary radiotherapy,the differences of curative effect and toxicity of two group were compared.Results There were 33 cases CR+PR,4 cases SD+PD in Group A,and 18 cases CR+PR,10 cases SD+PD in Group B,difference of short-term curative effect has statistical significance(χ2=5.849,P=0.016).The local control rates of 1-,2-,3-years in Group A are 86.2%,73.7%,43.7%,and 77.7%,59.6%,11.8% in Group B respectively,the difference has statistical significant(χ2=4.575,P=0.032);The survival rates of 1-,2-,3-years in Group A are 88.5%,75.4%,47.6%,and 78.2%,60.0%,23.8% in Group B respectively,the difference has statistical significant(χ2=4.140,P=0.042);Toxicity:The incidences of radiation cystitis in Group A and B were 10.8%,32.1%,the difference has statistical significant (χ2=4.533,P=0.033);the incidences of radiation proctitis in Group A and B were 13.5%,39.3%,the difference has statistical significant(χ2=5.705,P=0.017);the incidences of radiation pelvic Group A and B were 13.5%,14.3%,the difference has fibrosis in not statistical significant(χ2=0.008,P=0.929).Conclusions Compared with three-dimensional conformal+intracavitary radiotherapy,the interstitialimplantation+ intensity-modulated conformal brachytherapy for recurrent cervical cancer patients has obviously advantages,and has the characteristics of good curative effect,short course,mild side-effect.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第7期1896-1900,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
宫颈肿瘤
近距离放射疗法
放射疗法
调强适形
组织间插植
Uterine cervical neoplasms
Brachytherapy
Radiotherapy,intensity-modulated
Inter-organizational
